血液红细胞分布宽度在扩张性心肌病患者心、肾功能评估中的作用

The roles of red cell distribution width in the heart and renal functional assessment of dilated cardiomyopathy patients

目的探讨血液红细胞分布宽度(RDW)在扩张性心肌病(DCM)患者心脏泵血功能及肾功能损害评估中的作用。方法依据纽约心功能评级法(NYHA)评级标准,将44例DCM患者分为NYHAⅡ级13例、NYHAⅢ级14例和NYHAⅣ级17例。另取同期40名健康志愿者为对照组。对照组及DCM患者均于入院后第2日清晨空腹取血,测定血液RDW及血肌酐(Cr)水平,计算肾小球滤过率(GFR);同日行心脏彩色多普勒超声检查,测定左心室射血分数(LVEF);分析RDW与GFR、LVEF之间的相关性。结果与对照组相比,DCM患者血液RDW、Cr显著升高,而LVEF、GFR显著降低(P均<0.01)。组间比较结果显示,NYHAⅢ及NYHAⅣ组患者血液RDW、Cr水平显著高于NYHAⅡ组,而GFR、LVEF显著低于NYHAⅡ组(均P<0.05或0.01)。DCM患者血液RDW与LVEF、GFR均呈负相关性(r=-0.544,P<0.01;r=-0.406,P<0.01),GFR与LVEF呈正相关性(r=0.339,P<0.05)。结论 DCM患者血液RDW与心、肾功能之间存在相关性,RDW能够成为DCM患者心、肾功能评估的简便观察指标之一。

Objective To investigate the roles of red cell distribution width in the cardiac blood- pumping function and renal lesion assessment of dilated cardiomyopathy（ DCM） patients. Methods 44 dilated cardiomyopathy patients and 40 healthy volunteers were chosen into this study. According to NYHA classification,13 patients in NYHA class II,14 patients in NYHA class III and 17 patients in NYHA cases IV.The blood sample were taken in the morning of the day after admission with empty stomach. RDW and creatinine（ Cr） were detected in all the DCM patients and healthy volunteers. Glomerular filtration rate（ GFR） was calculated. Left ventricular ejection fraction（ LVEF） were detected by heart color Doppler in the same day. The correlation among RDW,GFR and LVEF were analyzed. Results Compared to healthy volunteers,RDW and Cr were elevated significantly while LVEF and GFR decreased in DCM patients. Comparisons among the DCM patients groups,RDW and Cr in NYHA class III and NYHA class IV were significantly higher than those in NYHA class II group,while GFR and LVEF were significantly lower. There was a positive correlation between GFR and LVEF（ r = 0. 339,P〈0. 05）,a negative correlation between RDW and LVEF（ r=- 0. 544,P〈0. 01）,RDW and GFR（ r =- 0. 406,P〈0. 01）. Conclusion RDW is correlated to cardiac blood- pumping function and renal lesion in DCM patients. It can be one of the convenient markers to evaluate the cardiac blood- pumping function and renal lesion of DCM patients.